Relationship of race/ethnicity with door-to-balloon time and mortality in patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction: Findings from get with the guidelines-coronary artery disease

Matthew A. Cavender, Andrew N. Rassi, Gregg C. Fonarow, Christopher P. Cannon, W. Frank Peacock, Warren K. Laskey, Adrian F. Hernandez, Eric D. Peterson, Margueritte Cox, Marie Grau-Sepulveda, Lee H. Schwamm, Deepak L. Bhatt

Research output: Contribution to journalArticlepeer-review

Abstract

Background Prior studies have described racial/ethnic disparities in door-to-balloon (DTB) time for patients undergoing primary percutaneous coronary intervention (PCI). We sought to compare DTB time between different racial/ethnic groups undergoing primary PCI for ST-elevation myocardial infarction in Get With the Guidelines (GWTG). Hypothesis There may be differences in D2B time associated with race/ethnicity. Methods We identified 7445 white (n = 6365), African American (n = 568), and Hispanic (n = 512) patients undergoing primary PCI. Results There were no differences in the median DTB time between white (74 minutes; intraquartile range [IQR], 54-99), African American (77 minutes; IQR, 57-100), and Hispanic (75 minutes; IQR, 56-100) (P = 0.13) patients. There were no crude differences in DTB time ≤90 minutes; however, after adjusting for confounders, African American race was associated with lower odds of DTB time ≤90 minutes (odds ratio [OR]: 0.84; 95% confidence interval [CI]: 0.70-0.99; P = 0.04). This association was seen in African American males (OR: 0.66; 95% CI: 0.55-0.80) but not African American females (OR: 1.27; 95% CI: 0.96-1.68). Overall, Hispanic ethnicity was not associated with a difference in DTB time ≤90 minutes (OR: 0.98; 95% CI: 0.77-1.25; P = 0.88); although Hispanic males did have a slightly longer median DTB time compared with whites. During the study, the proportion of patients with DTB times ≤90 minutes increased for all groups, and mortality was similar between groups (white 3.8%, African American 3.0%, Hispanic 4.1%, P = 0.62). Conclusions In GWTG-Coronary Artery Disease, small differences in DTB times persist among different races/ethnicities. However, the proportion achieving DTB times ≤90 minutes has increased substantially for all patients over time, and there was no association between race/ethnicity and in-hospital mortality.

Original languageEnglish (US)
Pages (from-to)749-756
Number of pages8
JournalClinical Cardiology
Volume36
Issue number12
DOIs
StatePublished - Dec 2013
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'Relationship of race/ethnicity with door-to-balloon time and mortality in patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction: Findings from get with the guidelines-coronary artery disease'. Together they form a unique fingerprint.

Cite this